Provider Demographics
NPI:1255300190
Name:ASHLAND PHYSICAL THERAPY ASSOCIATES INC
Entity Type:Organization
Organization Name:ASHLAND PHYSICAL THERAPY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-798-1112
Mailing Address - Street 1:203 N WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-1623
Mailing Address - Country:US
Mailing Address - Phone:804-798-1112
Mailing Address - Fax:804-798-1171
Practice Address - Street 1:203 N WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-1623
Practice Address - Country:US
Practice Address - Phone:804-340-1193
Practice Address - Fax:804-340-1930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA677040OtherSOUTHERN HEALTH
VADD5332OtherRAILROAD MEDICARE
VA192012OtherANTHEM
VA6404543OtherUNITED HEALTH CARE
VA7733682OtherAETNA
VAC09247Medicare PIN